Greenfield Skilled Nursing And Rehabilitation

Review of facility policy titled, Abuse Neglect, Exploitation and Misappropriation Prevention Program, dated 04/2021 revealed Residents had the right to be free from misappropriation.

Facility shall protect residents from misappropriations by anyone including facility staff.

Facility shall develop and implement policies and protocols to prevent and identify misappropriation.

This deficiency represents non-compliance investigated under Complaint Number 1342630 and 2580694.

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

08/20/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Greenfield Skilled Nursing and Rehabilitation

238 South Washington Street Greenfield, OH 45123

SUMMARY STATEMENT OF DEFICIENCIES

persons involved in the alleged incident.

Upon receiving allegations, the Administrator was responsible for determining what actions were needed for resident protection.This deficiency represents non-compliance investigated under Complaint Number 1342630 and Complaint Number 2580694.

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

08/20/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Greenfield Skilled Nursing and Rehabilitation

238 South Washington Street Greenfield, OH 45123

SUMMARY STATEMENT OF DEFICIENCIES

signed discharge paperwork with Resident #48's son (Power of Attorney (POA)). Resident #48 discharged with her POA.

The note dated 05/22/25 from Social Services #210 revealed Resident #48 was discharging home with her son and home health and appointments were set up.Review of Resident #48's discharge Minimum Data Set (MDS) assessment dated [DATE] revealed a Brief Interview of Mental Status (BIMS) of 06 indicating impaired cognition. It stated Resident #48 required set up assistance for eating, substantial maximum assistance for oral hygiene, shower/bathing, upper body dressing, personal hygiene, rolling, sitting up in bed and sitting at the edge of the bed and she was dependent upon staff with toileting assistance, lower body dressing, placing footwear, mobility from sit to stand, chair to bed transfers, toilet transfers, and shower transfers.

Car transfers and walking 10 feet were not attempted due to medical or safety concerns.

Review of the discharge summary/discharge plan of care dated 05/22/25 revealed Resident #48 was discharged due to meeting therapy goals. It also stated Resident #48 was set up with home healthcare for aide services as well as physical and occupational therapy services and named Ross County Home Health as the provider.Interview on 08/14/25 at 1:15 P.M. with Therapy Director (TD) #60 revealed Resident #48 was cut from therapy and had requested to discharge home with her family at that time instead of paying privately. TD #60 revealed Resident #48's family was reluctant about taking her home and she felt the resident had pressured her family to take her home at discharge.Interview on 08/14/25 at 4:00 P.M. with Administrator revealed Resident #48's insurance informed the facility on 05/14/25 that her days were about to be exhausted and she had seven days left, with the last covered day being 05/21/25.

She confirmed the note mentioned the facility was to provide discharge planning.Interview on 08/18/25 at 11:56 A.M. with Home Health Agency: Ross County Home Health revealed they denied the referral for Resident #48 and stated they were out of network with her insurance.

They stated they received the referral on 05/22/25 and informed Social Services staff on 05/22/25 they were out of network.

They revealed they did not hear back and followed up with a second email informing the facility they were out of network on 06/01/25, and again did not receive any response or confirmation back.

They confirmed they had never met with Resident #48 or initiated services.Interview on 08/18/25 at 12:25 P.M. with Director of Nursing (DON) revealed she had an expectation of a safe discharge plan and the previous social services staff should have confirmed acceptance of a home health agency.

The DON confirmed the discharge summary did not give an accurate reason for discharge as it stated the resident met therapy goals.

She also acknowledged the agency listed did not begin any services and confirmed the facility sent Resident #48 home without the needed and recommended services, which was not a safe discharge plan.Interview on 08/18/25 at 1:55 P.M. with Regional Nurse (RN) #200 confirmed the facility had no evidence of Resident #48 having an accepted home health agency at the time of discharge. RN #200 confirmed the facility only had evidence that two referrals were sent on 05/22/25 and none were sent prior to the day of discharge. RN #200 confirmed the facility had no evidence of prior discharge planning and no evidence a discharge care conference was held. RN #200 confirmed she received an email in June 2025 about referrals for Resident #48 and stated it was not our job to ensure the resident had services arranged prior to discharge to ensure a safe discharge plan.Interview on 08/18/25 at 1:55 P.M. with Regional Nurse (RN) #200 and Regional Account Manager (RAM) #205 reported the facility had discussions with Resident #48 and her family regarding difficulties with the insurance and acknowledged the facility had no evidence of the discussions and no documentation of difficulties with discharge planning.This deficiency represents non-compliance investigated under Complaint Number 2581704.

Facility ID: